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    1. Appearance of Polypoidal Lesions in Patients With Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomographic Angiography

      Appearance of Polypoidal Lesions in Patients With Polypoidal Choroidal Vasculopathy Using Swept-Source Optical Coherence Tomographic Angiography

      Importance Polypoidal choroidal vasculopathy (PCV) is a major cause of visual loss worldwide, particularly in Asia, and the appropriate understanding of the structures in PCV previously described as polypoidal lesions is important for understanding their pathogenesis, diagnosis, and prognosis. Objective To report the morphologic characteristics of polypoidal lesions and their association with branching vascular networks (BVNs) in eyes with PCV using swept-source optical coherence tomographic angiography (SS-OCTA). Design, Setting, and Participants This cross-sectional observational study included 20 participants recruited from Shanghai General Hospital with a diagnosis of PCV based on the presence of focal hyperfluorescent spots on indocyanine green angiography ...

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    2. Sensitivity and Specificity of Potential Diagnostic Features Detected Using Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography for Polypoidal Choroidal Vasculopathy

      Sensitivity and Specificity of Potential Diagnostic Features Detected Using Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography for Polypoidal Choroidal Vasculopathy

      Importance The use of indocyanine green angiography (ICGA) is a criterion standard for diagnosing polypoidal choroidal vasculopathy (PCV), an endemic and common cause of vision loss in Asian and African individuals that also presents in white individuals. However, the use of ICGA is expensive, invasive, and not always available at clinical centers. Therefore, knowing the value of certain features detected using fundus photography (FP), optical coherence tomography (OCT), and fluorescein angiography (FA) to diagnose PCV without ICGA could assist ophthalmologists to identify PCV when ICGA is not readily available. Objective To explore the sensitivity, specificity, and predictive accuracy of potential ...

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    3. Swept-Source Optical Coherence Tomography Angiography of Retinal Arterial Macroaneurysm With Overlying Hemorrhage

      Swept-Source Optical Coherence Tomography Angiography of Retinal Arterial Macroaneurysm With Overlying Hemorrhage

      A patient in their 90s with hypertension and diabetes type 2 noted the sudden onset of decreased visual acuity of 20/70 OS due to a subinternal limiting membrane macular hemorrhage. Blood obscured the view posteriorly, evidenced by blocked fluorescence exceeding 5 minutes on fluorescein angiography ( Figure , A). Swept-source optical coherence tomography angiography (SS-OCTA) demonstrated a retinal arterial macroaneurysm ( Figure , B). The SS-OCTA uses scatter from high-speed acquisition (100 000 A-scans/s) with a long center wavelength (1040-1060 nm), 1 allowing for deep penetration of light through retinal tissue and, in this case, hemorrhage. Although indocyanine green angiography can be ...

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    4. Association Between Parapapillary Choroidal Vessel Density Measured With Optical Coherence Tomography Angiography and Future Visual Field Progression in Patients With Glaucoma

      Association Between Parapapillary Choroidal Vessel Density Measured With Optical Coherence Tomography Angiography and Future Visual Field Progression in Patients With Glaucoma

      Importance Investigating the vascular risk factors of glaucoma progression is important to individualize treatment; however, few studies have investigated these factors because the available methods have proven insufficient to evaluate the vascular features of patients with glaucoma. Recently, the advent of optical coherence tomography angiography (OCT-A) allowed both qualitative and quantitative microvascular data to be obtained, to in turn evaluate the perfusion status of different retinal layers. Objective To determine whether baseline parapapillary choroidal vessel density (VD) as measured by OCT-A was associated with future glaucoma progression. Design, Setting, and Participants A prospective, observational, comparative study was conducted at Seoul ...

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    5. Promise of Optical Coherence Tomography Angiography in Determining Progression of Glaucoma

      Promise of Optical Coherence Tomography Angiography in Determining Progression of Glaucoma

      laucoma is recognized as a multifactorial disease. Although its causality is unknown, damage from glaucoma is highly interlinked to optic nerve and retinal blood flow. 1 Any advancement in the emerging technology of optical coherence tomography (OCT) angiography as a means of measuring optic nerve and retinal blood flow can promote our understanding of the pathophysiologic characteristics underlying glaucoma, improve diagnosis and prognosis, and likely affect the assessment of other ocular diseases.

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    6. Comparing the Risk Factors of Plaque Rupture and Failed Plaque Healing in Acute Coronary Syndrome

      Comparing the Risk Factors of Plaque Rupture and Failed Plaque Healing in Acute Coronary Syndrome

      The article by Vergallo et al 1 in this issue of JAMA Cardiology supports a hypothesis that healed plaques are a marker for reduced acute coronary syndrome (ACS) risk. This commentary expands on this idea by examining a mechanistic hypothesis of their results beyond looking at healing just as a marker. Specifically, failed healing, which correlated in the study by Vergallo et al 1 with long core axial extent, predisposes plaque ruptures to progress to ACS. Acute coronary syndrome may require a double hit of both rupture and impaired healing. This is somewhat analogous to the situation in oncology, where ...

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    7. Coronary Atherosclerotic Phenotype and Plaque Healing in Patients With Recurrent Acute Coronary Syndromes Compared With Patients With Long-term Clinical Stability An In Vivo Optical Coherence Tomography Study

      Coronary Atherosclerotic Phenotype and Plaque Healing in Patients With Recurrent Acute Coronary Syndromes Compared With Patients With Long-term Clinical Stability An In Vivo Optical Coherence Tomography Study

      Importance At one end of the coronary artery disease (CAD) spectrum, there are patients with multiple recurrent acute coronary syndromes (rACS), and at the other end there are those with long-standing clinical stability. Predicting the natural history of these patients is challenging because unstable plaques often heal without resulting in ACS. Objective To assess in vivo the coronary atherosclerotic phenotype as well as the prevalence and characteristics of healed coronary plaques by optical coherence tomography (OCT) imaging in patients at the extremes of the CAD spectrum. Design, Setting, and Participants This is an observational, single-center cohort study with prospective clinical ...

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    8. Optical Coherence Tomography Angiography of Retinal-Choroidal Anastomosis in Toxoplasmosis Chorioretinitis

      Optical Coherence Tomography Angiography of Retinal-Choroidal Anastomosis in Toxoplasmosis Chorioretinitis

      A young adult was examined for follow-up of toxoplasmosis chorioretinitis that was diagnosed and treated during early childhood. Two subsequent flare-ups were treated with atovaquone, combined trimethoprim and sulfamethoxazole, and oral prednisone. Visual acuity was 20/20 OD. Ophthalmoscopic examination results demonstrated an inactive temporal chorioretinal scar with an apparent retinal-choroidal anastomosis ( Figure ). Optical coherence tomography angiography was performed through the anastomosis. Enface images ( Figure ) of the retinal and choroidal circulations confirmed that there was an anastomotic flow between the retinal venous and choroidal circulations ( Figure ). We postulate that this anastomosis resulted from the structural damage that was caused by ...

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    9. Foveal Neovascularization Detected by Optical Coherence Tomography Angiography in Incontinentia Pigmenti

      Foveal Neovascularization Detected by Optical Coherence Tomography Angiography in Incontinentia Pigmenti

      A 5-year-old girl received a diagnosis of incontinentia pigmenti by skin biopsy results. Her best-corrected visual acuity was 20/32 OD. Fluorescein angiography showed nonperfusion and leakage from neovascularization (NV) in the temporal peripheral retina in that eye. Optical coherence tomography (OCT) angiography results showed foveal NV and parafoveal capillary nonperfusion ( Figure ). Another OCT image demonstrated inner retinal thinning that corresponded to the region of parafoveal capillary nonperfusion. Scatter laser photocoagulation was applied to the peripheral nonperfusion areas of the retina.

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    10. Estimating Retinal Sensitivity Using Optical Coherence Tomography With Deep-Learning Algorithms in Macular Telangiectasia Type 2

      Estimating Retinal Sensitivity Using Optical Coherence Tomography With Deep-Learning Algorithms in Macular Telangiectasia Type 2

      Importance As currently used, microperimetry is a burdensome clinical testing modality for testing retinal sensitivity requiring long testing times and trained technicians. Objective To create a deep-learning network that could directly estimate function from structure de novo to provide an en face high-resolution map of estimated retinal sensitivity. Design, Setting, and Participants A cross-sectional imaging study using data collected between January 1, 2016, and November 30, 2017, from the Natural History Observation and Registry of macular telangiectasia type 2 (MacTel) evaluated 38 participants with confirmed MacTel from 2 centers. Main Outcomes and Measures Mean absolute error of estimated compared with ...

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    11. Assessment of Postoperative Morphologic Retinal Changes by Optical Coherence Tomography in Recipients of an Electronic Retinal Prosthesis Implant

      Assessment of Postoperative Morphologic Retinal Changes by Optical Coherence Tomography in Recipients of an Electronic Retinal Prosthesis Implant

      Importance The postoperative retinal changes at the interface between an implant electrode array and the retina and whether these anatomic changes have an association with the patient visual performance are unknown. Objective To report morphologic changes in recipients of an Argus II Retinal Prosthesis. Design, Setting, and Participants This consecutive, noncomparative case series study included a retrospective review of the preoperative and postoperative optical coherence tomography of 33 eyes among 33 individuals who underwent Argus II Retinal Prosthesis System implantation between October 28, 2011, and June 8, 2017, at 2 different centers, by the same surgeon (S.R.). Thirteen patients ...

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    12. Optical Coherence Tomography to Assess Anatomic Changes in Recipients of Electronic Retinal Implants Getting Closer to the Promised Land of Sight for All

      Optical Coherence Tomography to Assess Anatomic Changes in Recipients of Electronic Retinal Implants Getting Closer to the Promised Land of Sight for All

      They came to Bethsaida. Some people brought a blind man to him and begged him to touch him. 23 He took the blind man by the hand and led him out of the village; and when he had put saliva on his eyes and laid his hands on him, he asked him, “Can you see anything?” 24 And the man looked up and said, “I can see people, but they look like trees, walking.” Mark 8:22-24 1

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    13. Vertical Hyperreflective Lesions on Optical Coherence Tomography in Vitreoretinal Lymphoma

      Vertical Hyperreflective Lesions on Optical Coherence Tomography in Vitreoretinal Lymphoma

      Importance Vitreoretinal lymphoma is a diagnostic challenge and the pathophysiology is still unclear. Objective To describe an imaging finding seen on optical coherence tomography (OCT) of patients with vitreoretinal lymphoma. Design, Setting, and Participants This case series study was a retrospective medical record review of patients who received a diagnosis of vitreoretinal lymphoma at the Department of Ophthalmology at Northwestern University between July 2014 and January 2016. Main Outcomes and Measures Optical coherence tomography findings in vitreoretinal lymphoma. Results We identified 7 patients (4 women [57.1%]; mean [range] age, 62.4 [45-75] years; 12 eyes) with intraocular lymphoma involving ...

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    14. Comparison of Optical Coherence Tomography With Fundus Photographs, Fluorescein Angiography, and Histopathologic Analysis in Assessing Coats Disease

      Comparison of Optical Coherence Tomography With Fundus Photographs, Fluorescein Angiography, and Histopathologic Analysis in Assessing Coats Disease

      Importance Coats disease is a rare pediatric vitreoretinopathy that can cause devastating visual and anatomic outcomes. Objective To compare optical coherence tomography (OCT) with fundus photographs, fluorescein angiography (FA), and histopathologic findings in Coats disease. Design, Setting, and Participants This retrospective cohort study was conducted in a single tertiary institution (Duke Eye Center) and identified 28 children with Coats disease through a review of medical records from December 2002 to January 2018. Four eyes were obtained from a biorepository for histopathologic analysis. Main Outcomes and Measures Macular OCT, fundus photographs, and FA results were reviewed and compared for morphological changes ...

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    15. Anterior Segment Optical Coherence Tomography Angiography in a Patient With Persistent Pupillary Membrane

      Anterior Segment Optical Coherence Tomography Angiography in a Patient With Persistent Pupillary Membrane

      The image depicts a 60-year-old woman with bilateral cataracts and no history of amblyopia, strabismus, or systemic diseases. Color slitlamp photography of the left eye ( Figure , A) showed a persistent pupillary membrane, with multiple iris strands extending from collarette to collarette and adhering to the anterior lens surface. Anterior segment optical coherence tomography angiography ( Figure , B) showed vessels originating from the lesser arterial circle of the iris and anastomosing with one another centrally. Persistent pupillary membrane results from incomplete involution of the tunica vasculosa lentis, which supplies the epithelium of the lens during fetal development. 1

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    16. Evaluation of a Combined Reflectance Confocal Microscopy–Optical Coherence Tomography Device for Detection and Depth Assessment of Basal Cell Carcinoma

      Evaluation of a Combined Reflectance Confocal Microscopy–Optical Coherence Tomography Device for Detection and Depth Assessment of Basal Cell Carcinoma

      Importance The limited tissue sampling of a biopsy can lead to an incomplete assessment of basal cell carcinoma (BCC) subtypes and depth. Reflectance confocal microscopy (RCM) combined with optical coherence tomography (OCT) imaging may enable real-time, noninvasive, comprehensive three-dimensional sampling in vivo, which may improve the diagnostic accuracy and margin assessment of BCCs. Objective To determine the accuracy of a combined RCM-OCT device for BCC detection and deep margin assessment. Design, Setting, and Participants This pilot study was carried out on 85 lesions from 55 patients referred for physician consultation or Mohs surgery at Memorial Sloan Kettering Skin Cancer Center ...

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      Mentions: Nicusor Iftimia
    17. Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings

      Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings

      Importance Biomarker testing for asymptomatic, preclinical Alzheimer disease (AD) is invasive and expensive. Optical coherence tomographic angiography (OCTA) is a noninvasive technique that allows analysis of retinal and microvascular anatomy, which is altered in early-stage AD. Objective To determine whether OCTA can detect early retinal alterations in cognitively normal study participants with preclinical AD diagnosed by criterion standard biomarker testing. Design, Setting, and Participants This case-control study included 32 participants recruited from the Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St Louis, St Louis, Missouri. Results of extensive neuropsychometric testing determined that all participants were ...

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    18. Use of En Face Swept-Source Optical Coherence Tomography Angiography in Identifying Choroidal Flow Voids in 3 Patients With Birdshot Chorioretinopathy

      Use of En Face Swept-Source Optical Coherence Tomography Angiography in Identifying Choroidal Flow Voids in 3 Patients With Birdshot Chorioretinopathy

      Importance Patients with birdshot chorioretinopathy (BSCR) can experience a delay in diagnosis owing to the challenges of identifying the condition prior to evolution of characteristic choroidal scars. An objective, noninvasive method for detecting early lesions in BSCR might have an effect on preventing vision loss in these patients. Objective To test the feasibility of swept-source optical coherence tomography angiography (SS-OCTA) in the detection of BSCR choroidal lesions and to use en face image analysis of choroidal layers to localize lesion depth. Design, Setting, and Participants Prospective, longitudinal, observational case series of 3 patients diagnosed as having BSCR at 1 of ...

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    19. Swept-Source Optical Coherence Tomography Angiography of Microaneurysms in Myopic Retinoschisis

      Swept-Source Optical Coherence Tomography Angiography of Microaneurysms in Myopic Retinoschisis

      A woman in her early 30s presented with floaters that had been present for several years. Her best-corrected visual acuity was 1.5 (20/13) OU. Axial length was 27.93 mm OD and 27.35 mm OS. Numerous aneurysms were observed temporal to the macula, predominantly in the left eye ( Figure , A). Swept-source optical coherence tomography angiography confirmed that these aneurysms were located in the retinoschisis cavity ( Figure , B). Fluorescein angiography showed tortuosity of capillaries and aneurysms around the macular with minimal leakage from the aneurysms. She did not have any history of systemic diseases, including diabetes. Aneurysmlike structures ...

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    20. Visualization of Capillary Dropout Emanating From an Optic Disc Pit Using Optical Coherence Tomography Angiography

      Visualization of Capillary Dropout Emanating From an Optic Disc Pit Using Optical Coherence Tomography Angiography

      A 9-year-old, healthy, asymptomatic child presented to our pediatric ophthalmology clinic for evaluation of optic disc anomalies. The patient was noted to have an optic disc pit in the left eye since the patient’s initial examination at 4 years of age by another pediatric ophthalmologist. Best-corrected visual acuity was 20/30 OS. Optical coherence tomography angiography (AngioVue; OptoVue) was performed and demonstrated full vascularization of the right optic nerve head ( Figure , A) and a radial spoke of capillary dropout emanating from the optic disc pit of the left eye ( Figure , B). Because there were no signs of active maculopathy ...

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    21. Utility of Optical Coherence Tomography for Guiding Laser Therapy Among Patients With Recurrent Respiratory Papillomatosis

      Utility of Optical Coherence Tomography for Guiding Laser Therapy Among Patients With Recurrent Respiratory Papillomatosis

      Importance Recurrent respiratory papillomatosis (RRP) is a viral-induced disease caused by human papillomavirus and the second leading cause of dysphonia in children; however, neither a cure nor a definitive surgical treatment is currently available for RRP. Although laser therapy is often used in the treatment of RRP, the lack of real-time laser-tissue interaction feedback undermines the ability of physicians to provide treatments with low morbidity. Therefore, an intraoperative tool to monitor and control laser treatment depth is needed. Objective To investigate the potential of combining optical coherence tomography (OCT) with laser therapy for patient-tailored laryngeal RRP treatments. Design, Setting, and ...

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    22. Serial Combined Wide-Field Optical Coherence Tomography Maps for Detection of Early Glaucomatous Structural Progression

      Serial Combined Wide-Field Optical Coherence Tomography Maps for Detection of Early Glaucomatous Structural Progression

      Importance Both parapapillary and macular areas are important in determining the progression of early glaucoma. However, no attempt has been made to assess the progression of glaucoma in images that combine the 2 areas. Objective To evaluate the potential usefulness of serial analysis of combined wide-field optical coherence tomography (OCT) maps for detection of structural progression in patients with early glaucoma. Design, Setting, and Participants Retrospective observational study. Patients with early primary open-angle glaucoma with a minimum of 3-year follow-up involving serial spectral-domain OCT measurement were analyzed. Patients were divided into a nonprogressor group (n = 47) and a progressor group ...

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    23. Improving Access—but Not Outcomes—With Iris Optical Coherence Tomography Angiography

      Improving Access—but Not Outcomes—With Iris Optical Coherence Tomography Angiography

      Throughout the past 2 decades, the exquisite, real-time ocular imaging attainable with optical coherence tomography (OCT) has transformed the practice of ophthalmology. Further increases in processing speed have led to the introduction of OCT angiography (OCT-A). 1 Preliminary work has shown that it is possible to use OCT-A to characterize the vasculature of the iris. 1 The current standard for assessing anterior segment circulation is iris angiography, but this approach has substantial drawbacks, most notably the need to administer an intravenous contrast agent, such as fluorescein or indocyanine green. In this issue of JAMA Ophthalmology , Velez and colleagues 2 explore ...

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    24. Association of Retinal Nerve Fiber Layer Thinning With Current and Future Cognitive Decline A Study Using Optical Coherence Tomography

      Association of Retinal Nerve Fiber Layer Thinning With Current and Future Cognitive Decline A Study Using Optical Coherence Tomography

      Importance Identifing potential screening tests for future cognitive decline is a priority for developing treatments for and the prevention of dementia. Objective To examine the potential of retinal nerve fiber layer (RNFL) thickness measurement in identifying those at greater risk of cognitive decline in a large community cohort of healthy people. Design, Setting, and Participants UK Biobank is a prospective, multicenter, community-based study of UK residents aged 40 to 69 years at enrollment who underwent baseline retinal optical coherence tomography imaging, a physical examination, and a questionnaire. The pilot study phase was conducted from March 2006 to June 2006, and ...

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